teacher field trip request form | Harambee Institute of Science and Technology Charter School

Teacher Field Trip Request Form

Request Form

School / Pick Up Location *
Teacher/Grade/Group *
Date Request Submitted *

TRIP LOGISTICS

Name of Destination *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Destination Contact Person/ Phone/Email *
Date of Trip (Allow 6 weeks for processing) *
Time Departing The School *HHMMAM/PM
Time Departing The Trip Location *HHMMAM/PM
Time Returning To The School *HHMMAM/PM
Number of Students *
Number of Chaperones *
Mode of Transportation *

If “Chartered Bus” or “Other”. Complete the following:

Name of Bus/Transit Company
Address of Bus/Transit Company
Telephone Number
Cost Per Student
Pre-trip Connected Lessons *
Subject(s), Objective(s), Standard(s) *
Learning Activities and Experiences on Trip *
In-School Extensions (Topics, Projects, etc.) *

PLEASE SEE NURSE FOR ANY STUDENT MEDICAL ADVISORIES.

Verification

Please enter any two digits *Example: 12
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